Race as a Predictor of Recurrence and Complications After Urethroplasty in Men With Urethral Stricture Disease

• Published in: Urology (Ridgewood, N.J.) Vol. 163; pp. 69 - 75
• Main Authors: Sawyer, Kathryn N., Cofield, Stacey S., Selph, John P.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2022
• Subjects: Constriction, Pathologic - surgery; Humans; Male; Middle Aged; Neoplasm Recurrence, Local - surgery; Recurrence; Retrospective Studies; Treatment Outcome; Urethra - surgery; Urethral Stricture - etiology; Urethral Stricture - surgery; Urologic Surgical Procedures, Male - adverse effects; Urologic Surgical Procedures, Male - methods
• ISSN: 0090-4295; 1527-9995; 1527-9995
• DOI: 10.1016/j.urology.2021.10.038

To determine the role of race in surgical outcomes of and complications after urethroplasty. A single institution, retrospective review was conducted from 2011 to 2019 on male patients ≥18 years of age who underwent urethroplasty. Exclusion criteria included previous urethral cancer, lack of follow up, or revision urethroplasty. Failure of urethroplasty was defined as requiring revision surgery or recurrence on imaging or cystoscopy. Risk factors for recurrence were determined using descriptive statistics, Wilcoxon comparisons, and multivariate logistic regression. Three hundred and seven patients were identified with 234 patients meeting inclusion criteria. 63.2% identified as White/Caucasian (CA), 32.5% Black/African American (AA), and 4.3% other race. Mean age was 49.4 years. Between CA and AA patients, there was no difference in mean age, body mass index, smoking status, prior urethroplasty, or prior dilation/DVIU. CAs were more likely to have a fossa navicularis stricture compared to AAs (P = .0094), but there were no significant differences in bulbar, penile, or posterior stricture rates (all P >.05) or length (P = .32). The overall stricture recurrence rate was 15.8% with a median of 242 days to recurrence and no significant difference by race for either outcome (P = .83, P = .64). The only predictor of stricture recurrence was prior dilation/DVIU (P = .0404, OR 2.3, 95% CI 1.0, 5.6). Overall complication rate was 17.5%, with no difference between CA and AAs rates (P = .83) or complication type (P = .62). There was no significant difference in the rate of surgical failure for urethral stricture repair based on race. The only predictor of surgical failure was having a prior urethral dilation/DVIU.